Job description

Position: Care Navigator

Location:100% Remote **MUST BE LOCATED IN NEW YORK**

Duration: 6 Month CTH

Start Date: ASAP

Description:

Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.

As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 6 industry leader.

Primary Responsibilities:

• Manage the intake of members or the admission/discharge information post notification
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Resolve inquiries from members and/or providers
• applies knowledge/skills to a range of moderately complex activities.
• Demonstrates great depth of knowledge/skills in own function.
• Sometimes acts as a technical resource to others in own function.
• Proactively identifies solutions to non-standard requests.
• Solves moderately complex problems on own.
• Works with team to solve complex problems.
• Plans, prioritizes, organizes and completes work to meet established objectives.
• May coordinate work of other team members.

Requirements:

• *Been in your most recent role for at least a year **
• Located in New york
• 1 year of experience working in a call center environment
• 1 year of Healthcare customer service experience
• Experience working with a large health insurer
• Able to navigate technology
• At least 1 year of previous experience working remote
• You have a HIPPA compliant remote work space
• Must have access to plug in an ethernet cord to your device for this position.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 12 hour shift
• 8 hour shift
• Monday to Friday
• Weekend availability

Application Question(s):

• Are you located in New York?
• How many years of call center experience do you have?
• What health insurance organizations have you worked for?
• Have you worked with medicare or Medicaid members?
• On average, How many inbound or outbound calls would you handle per day?

Work Location: Remote

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